Incidence, risk factors and mortality of tuberculosis in Danish HIV patients 1995-2007

Background Human Immunodeficiency Virus (HIV) infection predisposes to tuberculosis (TB). We described incidence, risk factors and prognosis of TB in HIV-1 infected patients during pre (1995-1996), early (1997-1999), and late Highly Active Antiretroviral Therapy (HAART) (2000-2007) periods. Methods...

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Vydané v:BMC pulmonary medicine Ročník 11; číslo 1; s. 26
Hlavní autori: Taarnhøj, Gry A, Engsig, Frederik N, Ravn, Pernille, Johansen, Isik S, Larsen, Carsten S, Røge, Birgit, Andersen, Aase B, Obel, Niels
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: London BioMed Central 23.05.2011
BMC
Predmet:
Adult
Africa - ethnology
AIDS-Related Opportunistic Infections - epidemiology
AIDS-Related Opportunistic Infections - mortality
Antiretroviral Therapy, Highly Active
Asia - ethnology
CD4 Lymphocyte Count
Cohort Studies
Critical Care Medicine
Denmark - epidemiology
Female
HIV Infections - complications
HIV Infections - drug therapy
Humans
Incidence
Intensive
Internal Medicine
Kaplan-Meier Estimate
Male
Medicine
Medicine & Public Health
Middle Aged
Pneumology/Respiratory System
Regression Analysis
Research Article
Retrospective Studies
Risk Factors
Tuberculosis, Pulmonary - epidemiology
Tuberculosis, Pulmonary - mortality
Denmark
Asia
Africa
Human Immunodeficiency Virus Transmission
Injection Drug User
Human Immunodeficiency Virus Infection
Human Immunodeficiency Virus Patient
Human Immunodeficiency Virus
ISSN:1471-2466, 1471-2466
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Shrnutí:Background Human Immunodeficiency Virus (HIV) infection predisposes to tuberculosis (TB). We described incidence, risk factors and prognosis of TB in HIV-1 infected patients during pre (1995-1996), early (1997-1999), and late Highly Active Antiretroviral Therapy (HAART) (2000-2007) periods. Methods We included patients from a population-based, multicenter, nationwide cohort. We calculated incidence rates (IRs) and mortality rates (MRs). Cox's regression analysis was used to estimate risk factors for TB infection with HAART initiation included as time updated variable. Kaplan-Meier was used to estimate mortality after TB. Results Among 2,668 patients identified, 120 patients developed TB during the follow-up period. The overall IR was 8.2 cases of TB/1,000 person-years of follow-up (PYR). IRs decreased during the pre-, early and late-HAART periods (37.1/1000 PYR, 12.9/1000 PYR and 6.5/1000 PYR respectively). African and Asian origin, low CD4 cell count and heterosexual and injection drug user route of HIV transmission were risk factors for TB and start of HAART reduced the risk substantially. The overall MR in TB patients was 34.4 deaths per 1,000 PYR (95% Confidence Interval: 22.0-54.0) and was highest in the first two years after the diagnosis of TB. Conclusions Incidence of TB still associated with conventional risk factors as country of birth, low CD4 count and route of HIV infection while HAART reduces the risk substantially. The mortality in this patient population is high in the first two years after TB diagnosis.
Bibliografia:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
content type line 23
ISSN:1471-2466
1471-2466
DOI:10.1186/1471-2466-11-26